Keeping It Real

Google the name of any well-known drug, and in addition to a brand Web page, a Wikipedia entry, and listings in a handful of directories, you'll see dozens, if not hundreds, of online pharmacies offering to send you the product in discreet packaging at rock-bottom prices. This raises a scary question: If you send in your money, what will you get?

Not long ago, MarkMonitor, a brand-protection firm known for its annual "brand jacking" report, decided to find out. To give the online pharmacies a fair shot, the company searched for legitimate-looking sites—the ones that ranked high in keyword searches, and purchased legitimate online advertising—and attempted to place orders through five such sites.

According to Te Smith, vice president of communications at MarkMonitor, the process didn't go as smoothly as expected. At four of the five sites, technical glitches made it impossible to use online shopping carts. "It's possible that some of these pharmacies are [virtual] storefronts for the same back-end Web site," Smith told Pharm Exec. "A scammer could put up a variety of 'storefronts,' each emphasizing a different drug or condition in order to maximize overall traffic, but funnel those purchasers to the same back-end shopping cart to process the transaction."

Police and pharma companies have turned up counterfeit pharmaceuticals produced under deplorable conditions in unsavory environments. The lab above was discovered by Pfizer during a raid in China. The company is cracking down on rogue drug plants by constantly changing its packaging and responding to every call.

The one successful purchase was a global affair. The site,
http://Interpill.com/, claimed to be located in the United States, and used a phone number with a Southern California area code. However, the IP address of the site was Russian, as was the accent of the operator who took the order. The credit card, meanwhile, was billed from Israel, and the pills, which arrived eight weeks later, were shipped from India.

And what were they? MarkMonitor was not able to determine that definitively, because the sample proved too small. The active ingredient was a generic in the same class of drugs, possibly legitimately produced for some other market. But one thing was certain. "They were not the same brand that we ordered," Smith says.

As of November, Interpill is still an active Web site with a fairly slick home page. However, the site appears on dozens of lists of fraudulent Web sites, and has received hundreds complaints from customers. Requests for an interview were denied.

The Threat is Real?

MarkMonitor's experiment—one purchase, resulting in one fake—is obviously anecdotal, but it matches a growing body of experience. Repeated FDA mail intercepts over the past few years have turned up masses of counterfeit drugs going to individual consumers, while there have been at least two highly publicized cases in which counterfeit Lipitor and Procrit have entered the US drug distribution system. Though no one expects it to be easy to trace the effects of counterfeit pharmaceuticals on the health of consumers, there has been one well-documented fatality—a Canadian woman poisoned by counterfeit sedatives that contained dangerous metals, including uranium, strontium, selenium, aluminum, and arsenic.

While it's hard to quantify how much illegal prescription medicine changes hands each year, no one—not FDA or the pharmaceutical industry—is downplaying the threat. According to the Center for Medicine in the Public Interest, counterfeit drug sales are expected to reach $75 billion globally in 2010, an increase of more than 90 percent from 2005.

"There are millions and millions of packages trying to come into the United States each year. We have no idea what those millions and millions equate to, and it's very hard and resource intensive to actually get a good count; but the trend is that the numbers have been going up," says Ilisa Bernstein, FDA's director of pharmacy affairs.